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General NPI Number Information
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NPI Number | 1972736197
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Entity Type | Organization
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Legal Business Name | HALCYON FOUNDATION OF HOUSTON
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Dates
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Enumeration Date | 09/04/2009
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Last Update Date | 09/07/2009
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Provider Practice Location Address
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Address Line | 13518 MOBILE ST
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City | HOUSTON
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State | TX
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Zip | 77015-4418
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Country | US
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Telephone | 713-970-5781
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Fax |
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Provider Business Mailing Address
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Address Line | 13518 MOBILE ST
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City | HOUSTON
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State | TX
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Zip | 77015-4418
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Country | US
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Telephone | 713-970-5781
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. RICHARD BONTON
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Credential |
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Telephone | 713-970-5781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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